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Remission of lymphoma after drug withdrawal in rheumatoid arthritis

Irwin G S Lim and James V Bertouch
Med J Aust 2002; 177 (9): 500-501.

Rheumatoid arthritis is a common disorder. Its various articular and extra-articular manifestations are well described, but less well known is the association between rheumatoid arthritis and malignancy. There is an intrinsic risk of lymphoma, particularly non-Hodgkin's lymphoma, in rheumatoid arthritis. In determining causality, it is difficult to separate the effects of treatment from those of the disease itself — most patients with rheumatoid arthritis are treated with more than one immunosuppressive agent during the course of their disease. Cyclosporin has been implicated in the development of lymphoma, predominantly in association with transplantation.1,2 In addition, there are an increasing number of reports of B-cell lymphomas in rheumatoid arthritis patients that would seem to implicate methotrexate.3-10

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  • Irwin G S Lim1
  • James V Bertouch2

  • 1 Department of Rheumatology, Royal North Shore Hospital, St Leonards, NSW.
  • 2 Department of Rheumatology, Prince of Wales Hospital, Randwick, NSW.

Correspondence: bertouch@msn.com.au

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  • 8. Kono H, Inokuma S, Matsuzaki Y, et al. Two cases of methotrexate induced lymphomas in rheumatoid arthritis: an association with increased serum IgE. J Rheumatol 1999; 26: 2249-2253.
  • 9. Ferraccioli GF, Casatta L, Bartoli E, et al. Epstein–Barr virus-associated Hodgkin's lymphoma in a rheumatoid arthritis patient treated with methotrexate and cyclosporin A. Arthritis Rheum 1995; 38: 867-868.
  • 10. Kremer JM. Is methotrexate oncogenic in patients with rheumatoid arthritis? Semin Arthritis Rheum 1997; 26: 785-787.

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